Neurocognitive enhancement, or cosmetic neurology, offers the prospect of improving the learning, memory and attention skills of healthy individuals well beyond the normal human range. Much has been written about the ethics of such enhancement, but policy-makers in the USA, the UK and Europe have been reluctant to legislate in this rapidly developing field. However, the possibility of discrimination by employers and insurers against individuals who choose not to engage in such enhancement is a serious threat worthy of legislative intervention. (...) While lawmakers should not prevent individuals from freely pursuing neurocognitive enhancement, they should act to ensure that such enhancement is not coerced. This paper offers one model for such legislation, based upon a proposed US law, the Genetic Information Nondiscrimination Act of 2008, to address precisely this particular pitfall of the impending neuroscience revolution. (shrink)

Die Arbeit setzt sich mit der neuzeitlichen Theodizeefrage auseinander. In einem ersten Schritt wird versucht, den genuinen Gehalt der Philosophie von Leibniz darzustellen, dessen Werk für die weitere Diskussion dieser Thematik maßgeblich wurde. Dabei wird aufgewiesen, dass die Argumente von Leibniz empiristischen und fideistischen Bestreitungen einer Theodizee standzuhalten und den Glauben an den allmächtigen und gütigen Gott mit dem Phänomen menschlicher Freiheit in Verbindung zu bringen vermögen. In einem zweiten Schritt werden die Positionen von Kant und Leibniz konfrontiert. Dabei zeigt (...) sich, dass Kant den von Leibniz bezeichneten Weg nicht verwirft, sondern weiterführt und die Theodizeefrage konsequent in der Praxis menschlichen Weltumgangs zu verorten vermag. (shrink)

Russia's war against Ukraine has had devastating human consequences and destabilizing geopolitical effects. This roundtable takes up three critical debates in connection with the conflict: Ukraine's potential accession to the European Union; the role of Ukrainian nationalism in advancing democratization; and the degree of human rights accountability, not just for Russia, but also for Ukraine. In addition to challenging conventional wisdom on each of these issues, the contributors to this roundtable make a second, critically important intervention. Each essay explores the (...) problem of concealed political and normative commitments within much of the research on Russia's war against Ukraine by unearthing biases intrinsic to particular conceptualizations. The collection also questions the perceived separation between “interests” and “values” that permeates policy analysis. This roundtable further draws attention to the ethical problems that scholars and policymakers bring to policy debates through the occlusion of their preexisting political commitments. It argues for greater transparency around and awareness of the ways in which values, not just evidence, inform research findings and policy positions. (shrink)

Substituted judgment has increasingly become the accepted standard for rendering decisions for incapacitated adults in the USA. A broad exception exists with regard to patients with diminished capacity secondary to depressive disorders, as such patients’ previous wishes are generally not honoured when seeking to turn down life-preserving care or pursue aid-in-dying. The result is that physicians often force involuntary treatment on patients with poor medical prognoses and/or low quality of life as a result of their depressive symptoms when similarly situated (...) incapacitated patients without such depressive symptoms would have their previous wishes honoured via substituted judgment. This commentary argues for reconsidering this approach and for using a substituted judgment standard for a subset of EMP/LQL patients seeking death. (shrink)

Dieser Band ist der erste Teil einer Lekture von Hegels Phanomenologie des Geistes, in dem die ersten drei Hauptkapitel - d.h. -Bewusstsein-, -Selbstbewusstsein- und -Vernunft- - von Hegels erstem Hauptwerk umfassend kommentiert werden. Der Text entstand dabei wahrend eines uber viele Jahre laufenden Seminars, welches am Institut fur Philosophie der Universitat Wien unter Leitung von Professor Dr. Friedrich Grimmlinger abgehalten wurde und in dem der Hegelsche Text gemeinsam Satz fur Satz gelesen und ausgelegt wurde.".

A Philosophy of Mitzvot by Rabbi Dr. Gersion Appel sets forth the Hinnukh's objectives and his approach to revealing the religious and ethical meaning of the mitzvot. In his wide-ranging study, the author presents a comprehensive view of Jewish philosophy as developed by the Hinnukh and the classical Jewish philosophers. The Hinnukh emerges in this study as a great educator and moral and religious guide, and his classic work as a treasure-trove of Jewish knowledge, religious inspiration, and brilliant insight in (...) the molding of human character. (shrink)

Whether the law should permit individuals to opt out of accepted death standards is a question that must be faced and clarifiedWhile media coverage of the Terri Schiavo case in Florida has recently refocused public attention on end of life decision making, another end of life tragedy in Utah has raised equally challenging—and possibly more fundamental—questions about the roles of physicians and families in matters of death. The patient at the centre of this case was Jesse Koochin, a six year (...) old boy suffering from “inoperable and incurable” brain cancer. He had been undergoing care at Primary Children’s Medical Center in Salt Lake City since September 15, 2004 when “his tumor pushed his brain stem down through the skull”.1 Subsequently, two physicians independently determined that the child was “brain dead” and informed his parents that they would order life support removed within twenty four hours. Steve and Gayle Koochin overtly rejected the hospital’s definition of death. The couple, relying on traditional notions of cardiopulmonary death, obtained a restraining order to keep Jesse on a ventilator and ultimately removed the brain dead child from the hospital. The ongoing case raises the complex question of whether patients’ families should be permitted to opt out of widely accepted definitions of death in favour of their own standards.The definition of death has evolved rapidly in the United States over the past thirty five years. Until the middle of the twentieth century, the medical community, the legal system, and an overwhelming majority of the public understood death to …. (shrink)

ABSTRACTThis article pursues the question of the essence of Europe. It does not lie in the religious, cultural and geographical demarcations, but in the openness towards the other. The particular contribution of religion in this could lay in its apocalyptic tradition. This must not be understood as a violent end of history beset by fear. Rather it means the end of all virtual images and identities which serve to mask the fundamental vulnerability of man.

The health and fitness of United States presidents has been a matter of concern since the Constitutional Convention. Several United States presidents, including James Madison, James Garfield, and Woodrow Wilson, were significantly impaired during portions of their tenure. Yet how to address this issue has proved both ethically and politically challenging, increasingly so during our nation's current period of elevated polarization. This essay reviews the history of presidential impairment and the range of proposals that have been offered to address it. (...) Ultimately, the essay argues that any effort to require the release of medical records or to evaluate the president while in office is likely to prove ineffective and politically unworkable, but also that providing the public with more medical information about candidates and presidents is unlikely to prove useful to voters in rendering their decisions. (shrink)

As a result of workplace clean air regulations and strict guidelines imposed by the Joint Commission on Accreditation of Healthcare Organizations in 1993, most hospitals in the United States are now virtually smoke free. Although evidence suggests that these restrictions both cause smoking employees to consume fewer cigarettes per day and induce some employees to quit smoking entirely, the policies have also driven many healthcare providers—including physicians—onto the public sidewalks for their cigarette breaks. Patients entering many hospitals pass white-coated medical (...) students and residents puffing away at the curbside. (shrink)

Since several landmark legal decisions in the 1970s and 1980s, substituted judgment has become widely accepted as an approach to decision‐making for incapacitated patients that incorporates their autonomy and interests. Two notable exceptions have been cases involving minors and those involving cognitively or psychiatrically impaired individuals who never previously possessed the ability to contemplate the medical decisions involved in their care. While a best interest standard may have universal merit in pediatric cases, this paper argues that substituted judgement has been (...) rejected too broadly for “never‐capacitated” patients. It then lays out a three‐condition test for using substituted judgment in these cases. For a subset of “never‐capacitated” patients who belong to distinctive religious or cultural communities with clear medical values and have an appropriate surrogate, these values may prove helpful in vindicating the interests of the never‐capacitated and should not be blanketly dismissed. (shrink)

Aims to show graduate students and researchers the vital benefits of integrating mathematics into their study and experience of the physical world. This book details numerous topics from the frontiers of modern physics and mathematics such as convergence, Green functions, complex analysis, Fourier series and Fourier transform, tensors, and others.

One of the most fundamental tenets of medical research, enshrined in the World Medical Association’s Declaration of Helsinki, is that scientific investigation involving human beings requires the informed consent of the subjects.

The public discourse surrounding sex and severe disability over the past 40 years has largely focused on protecting vulnerable populations from abuse. However, health professionals and activists are increasingly recognising the inherent sexuality of disabled persons and attempting to find ways to accommodate their intimacy needs. This essay explores several ethical issues arising from such efforts.

Apolitical, amoral, an aesthete whose writings point toward some form of liberation: this is the figure who emerges from most recent scholarship on Friedrich ...

Through their sociopolitical activism, business leaders increasingly call for citizens to become more politically engaged in favor of a partisan position. This research develops and tests a framework that reveals that corporate sociopolitical activism can indeed elicit such political engagement but runs the risk of simultaneously inciting backlash from citizens who oppose the company’s envisioned political ends. Whereas politically congruent citizens perceive a company’s activism to be morally courageous and are thus inspired to support the company’s stance, politically incongruent citizens (...) feel threatened by the company’s activism and become politically engaged in protection of their political identity. Companies may, however, succeed in increasing moral courage attributions without simultaneously affecting citizens’ political identity threat by acting as first movers in their activism. A series of experiments, including a stimulus sampling approach with 30 real cases of corporate sociopolitical activism, lend support for this framework. The results provide several implications for the political responsibilities of business leaders in contemporary democracies. (shrink)

Between inventing the concept of a universal computer in 1936 and breaking the German Enigma code during World War II, Alan Turing, the British founder of computer science and artificial intelligence, came to Princeton University to study mathematical logic. Some of the greatest logicians in the world--including Alonzo Church, Kurt Gödel, John von Neumann, and Stephen Kleene--were at Princeton in the 1930s, and they were working on ideas that would lay the groundwork for what would become known as computer science. (...) Though less well known than his other work, Turing's 1938 Princeton PhD thesis, "Systems of Logic Based on Ordinals," which includes his notion of an oracle machine, has had a lasting influence on computer science and mathematics. This book presents a facsimile of the original typescript of the thesis along with essays by Andrew Appel and Solomon Feferman that explain its still-unfolding significance. A work of philosophy as well as mathematics, Turing's thesis envisions a practical goal--a logical system to formalize mathematical proofs so they can be checked mechanically. If every step of a theorem could be verified mechanically, the burden on intuition would be limited to the axioms. Turing's point, as Appel writes, is that "mathematical reasoning can be done, and should be done, in mechanizable formal logic." Turing's vision of "constructive systems of logic for practical use" has become reality: in the twenty-first century, automated "formal methods" are now routine. Presented here in its original form, this fascinating thesis is one of the key documents in the history of mathematics and computer science. (shrink)

Evidence‐based medicine has become both the mantra of clinical practice and the dominant contemporary approach to patient care. Gordon Guyatt et al. first proposed applying the concept to medical education in the early 1990s, arguing for training that “de‐emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale” in favor of “examination of evidence from clinical research”; over the following twenty‐five years, nearly every medical school and residency program in the United States incorporated these methods into its training. During this same period, (...) admissions requirements and protocols have continued to rely on subjective, non‐evidence‐based ideals largely developed a century earlier. In light of the continued underrepresentation of certain demographic groups among matriculants, as well as the national controversy surrounding admissions standards at undergraduate institutions—most notably embodied in the lawsuit by Students for Fair Admissions against Harvard University—the moment may be ripe for a radical reexamination of those requirements. (shrink)

Artificial intelligence (AI) holds considerable promise for transforming clinical diagnostics. While much has been written both about public attitudes toward the use of AI tools in medicine and about uncertainty regarding legal liability that may be delaying its adoption, the interface of these two issues has so far drawn less attention. However, understanding this interface is essential to determining how jury behaviour is likely to influence adoption of AI by physicians. One distinctive concern identified in this paper is a ‘negative (...) outcome penalty paradox’ (NOPP) in which physicians risk being penalised by juries in cases with negative outcomes, whether they overrule AI determinations or accept them. The paper notes three reasons why AI in medicine is uniquely susceptible to the NOPP and urges serious further consideration of this complex dilemma. (shrink)

Although considerable attention has been devoted to the concepts of “visible” and “invisible” victims in general medical practice, especially in relation to resource allocation, far less consideration has been devoted to these concepts in behavioral health. Distinctive features of mental health care in the United States help explain this gap. This essay explores three specific ways in which the American mental health care system protects potentially “visible” individuals at the expense of “invisible victims” and otherwise fails to meet the needs (...) of great numbers of people with serious psychiatric conditions: prioritization of the wrong patients, incentivization of excessive caution among providers, and a narrow definition of psychiatry's purview. While each of these practices has been discussed elsewhere in the literature, they are rarely considered as part of an interrelated and systemic problem. Reconceptualizing these three issues as aspects of the larger conflict between the interests of “visible” and “invisible” victims may prove a path toward reform. (shrink)

The model for capacity assessment in the United States and much of the Western world relies upon the demonstration of four skills including the ability to communicate a clear, consistent choice. Yet such assessments often occur at only one moment in time, which may result in the patient expressing a choice to the evaluator that is highly inconsistent with the patient’s underlying values and goals, especially if a short-term factor (such as frustration with the hospital staff) distorts the patient’s preferences (...) momentarily. These challenges are particularly concerning in cases, which arise frequently in hospital settings, in which patients demand immediate self-discharge, often during off-hours, while faced with life-threatening risks. This paper examines the distinctive elements that shape such cases and explores their ethical implications, ultimately offering a model for such situations that can be operationalized. (shrink)

Limitations on reproductive decision making, including forced sterilization and involuntary birth control, raise significant ethical challenges. In the United States, these issues are further complicated by a disturbing history of the abuse and victimization of vulnerable populations. One particularly fraught challenge is the risk of teratogenicity posed by moodstabilizing psychiatric medications in patients who are incapable of appreciating such dangers. Long-acting reversible contraception (LARC) offers an intervention to prevent pregnancy among individuals who receive such treatments, but at a cost to (...) their reproductive autonomy. This article examines the ethical issues involved in the use of involuntary LARC for patients on teratogenic psychiatric medications (TPMs) and argues that such an approach can only be justified as a last resort after a careful consideration of the alternatives and an assessment of potential risks and benefits. (shrink)

The integrity of the patient–physician relationship depends on maintaining professional boundaries. While ethicists and professional organisations have devoted significant consideration to the subject of sexual boundary transgressions, the subject of non-sexual boundaries, especially outside the mental health setting, has been largely neglected. While professional organisations may offer guidance on specific subjects, such as accepting gifts or treating relatives, as well as general guidance on transparency and conflict of interest, what is missing is a principle-based method that providers can use to (...) assess non-sexual interactions with patients that transcend norms of practice. This paper attempts to offer an operational model for such assessment that considers not only the traditional emphasis on beneficence, but also incorporates concerns over entanglement and concordance. (shrink)

The “Goldwater rule,” a policy adopted by the American Psychiatry Association in 1973, prohibits organization members from diagnosing or offering professional opinions regarding the mental health of public figures without both first-hand evaluation and authorization. Initially developed in response to a controversial survey of APA members during the 1964 Presidential election campaign, the ethics rule faced few large scale challenges until the election of Donald Trump in 2016. Since that time, a significant number of psychiatrists have either violated or criticized (...) the rule openly. This paper argues that whatever the initial merits of the rule, the prohibition has since been rendered obsolete by the combined lack of professional consensus supporting the policy, absence of a meaningful enforcement mechanism, and the credible statements of non-APA members in the mental health professions regarding public figures. (shrink)

ABSTRACT The EU’s activation of Article 7 procedures against Hungary and Poland signals that it is beginning to take seriously the illiberal turn in Central Europe. However, the likelihood that the EU can restrain populist and illiberal tendencies in Hungary and Poland in the near future is slim. Despite the efficacy of the EU and other international organizations in promoting liberalism in these countries in the past, similar efforts are hobbled by a lack of political will and by significant bureaucratic (...) hurdles. The impetus to protect the liberal institutions and practices developed after the collapse of communism must come from the combined efforts of additional external actors and, most of all, by strong pressure from below. (shrink)

One of the basic tenets of paediatric ethics is that competent parents may render healthcare decisions for children who are too young or too incapacitated to make meaningful medical choices for themselves. In the USA, many jurisdictions have expanded this principle to include the right to terminate a child's life support, including nutrition and hydration, when that child enters a persistent vegetative state. However, this approach to the withdrawal of care in the paediatric setting has been put to the test (...) by an increasing number of cases in which one or both parents are themselves accused of causing the child's life-threatening injuries. In such “mixed-motive” situations, parents may express a desire to keep a child on life support for religious or moral reasons; at the same time, forestalling the child's death may also prevent a murder charge against the accused parent. Principles need to be established for handling such tragic cases. (shrink)